World Neurosurg
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Surgical resection of diffuse low-grade gliomas (DLGGs) involving cortical eloquent areas and subcortical functional pathways represents a challenge in neurosurgery. Patient-specific, 3-dimensional (3D)-printed models of head and brain structures have emerged in recent years as an educational and clinical tool for patients, doctors, and surgical residents. ⋯ Spatial proximity of DLGG to cortical eloquent areas and subcortical tracts can be readily assessed in patient-specific 3D printed models with high fidelity. 3D-printed multimodal models could be helpful in preoperative patient consultation, surgical planning, and resident training.
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Deep brain stimulation (DBS) is an important treatment for patients with advanced Parkinson's disease (PD). Patients after DBS implantation need specialized programming to get optimal outcomes. However, access to timely and economical postoperative programming for many patients living in remote areas is limited. Teleprogramming, which refers to deliver real-time remote programming through Internet, can help to address this gap. ⋯ Remote programming may offer a feasible and acceptable approach to timely and economic management in patients with PD after DBS implantation.
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Craniotomies/craniostomies have been categorized as aerosol-generating procedures and are presumed to spread coronavirus disease 2019 (COVID-19). However, the presence of severe acute respiratory distress syndrome coronavirus 2 virus in the generated bone dust has never been proved. Our objective is to evaluate the presence of virus in the bone dust (aerosol) generated during emergency neurosurgical procedures performed on patients with active COVID-19. This would determine the true risk of disease transmission during the surgery. ⋯ The bone dust generated during craniotomy/stomy of active patients does not contain the virus. The procedure on an active patient is unlikely to spread the disease. However, a study with larger cohort would be confirmatory.
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Transradial access has been used increasingly for diagnostic cerebral angiography and neurointerventions. This requires development of a new skillset. Forming the Simmons catheter to catheterize the cerebral vessels is the most fundamental. Patient anatomy can complicate the formation of the Simmons catheter and the success of the procedure. The aim of this paper is to identify and describe the techniques that can be used transradially to facilitate the formation of the Simmons catheter for catheterization of the cerebral vessels. ⋯ Transradial artery access has become increasingly common in cerebral angiography and neurointerventions. We describe techniques used for the formation of the Simmons catheter, a fundamental skill necessary for transradial cerebral angiogram or neurointervention.
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Hemorrhage is a feared complication of cranial dural arteriovenous fistulas (DAVFs). Traditional grading systems including the Cognard and Borden classifications assess for this risk. We sought to define the specific angioarchitecture of ruptured lesions. ⋯ Hemorrhage from cranial DAVFs is mostly intraparenchymal. Venous aneurysms are common and very often responsible for the bleed. Embolization yields high cure rates and should be performed early because of risk of re-hemorrhage. However, in spite of hemorrhage, DAVFs have a relatively favorable clinical outcome.